Organization
LONGS DRUG STORES CALIFORNIA, L.L.C.
Active
Organization
LONGS DRUG STORES CALIFORNIA, L.L.C.
Active
Other names
CVS Pharmacy #09271
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY GRATTO (MANGER/PAYER RELATIONS)
(401) 770-7298
Entity
Organization
Contact information
Practice address
3619 W CALDWELL AVE, VISALIA, CA 93277-7067
(559) 732-5971
(559) 732-0844
Mailing address
1 CVS DR, BOX 1075 -PHARMACY ENROLLMENTS, WOONSOCKET, RI 02895-6146
(401) 765-1500
(401) 770-7108
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY49614
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0504945
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
1336181155
—
CA
01
—
FLU11286G
MASS IMMUNIZATION ROSTER BILLER
CA
Enumeration date
06/13/2006
Last updated
08/24/2011
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